MEDICARE: BURLINGTON LABORATORIES OF SARATOGA COUNTY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	8451	NY

General Provider Information

NPI Number	:	1427384304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURLINGTON LABORATORIES OF SARATOGA COUNTY, LLC

Provider Business Mailing Address
First Line	:	12 SPRING ST
Second Line	:
City	:	SCHUYLERVILLE
State	:	NY
Zip	:	12871-1049
Country	:	US
Telephone Number	:	518-695-3200
Fax Number	:	518-695-3230

Provider Business Practice Location Address
First Line	:	12 SPRING ST
Second Line	:
City	:	SCHUYLERVILLE
State	:	NY
Zip	:	12871-1049
Country	:	US
Telephone Number	:	518-695-3200
Fax Number	:	518-695-3230

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL CASARICO
Credential	:
Telephone Number	:	802-863-4105

Provider Enumeration Date	:	10/27/2009
Last Update Date	:	10/27/2009

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